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General NPI Number Information
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NPI Number | 1568159044
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Entity Type | Individual
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Provider Name | MICHAEL MEARS DMD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 6321 18TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-2941
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Country | US
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Telephone | 209-551-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 3505 PARKCREST DR
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City | MODESTO
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State | CA
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Zip | 95355-8611
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Country | US
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Telephone | 209-551-1990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 064926
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License Number State | NY
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